PUPILS
WITH ASD : TEACHING APPROACHES AND LITERACY

This set of notes provides a
summary of the particular needs among children with ASD in respect of the
development of literacy skills.Reference is made to the common visual strengths and to possible
difficulties in seeking to rely wholly or largely upon phonic strategies.

There is also reference to
hyperlexia, which is commonly but not uniquely found among individuals with
ASD, with a discussion of the characteristics of this condition and the needs
in terms of classroom practice.

An introductory set of
thoughts, concerning teaching strategies for children with autism and ASD, is
provided by Falk-Ross et al (2004).

Their focus was upon children
with Asperger Syndrome who have been identified in relatively large numbers
over the last 10+ years, and of whom a significant percentage may be included
within mainstream classes.

They describe this condition as a
grouping of physical and behavioural characteristics which can present
challenges for education, especially at primary school level when literacy
teaching requires inferential levels of analysis …. something which will place
the children concerned at a particular disadvantage.

There is a further complication
in that the signs and symptoms of this condition may not be readily recognised
for what they are, and the subtleties of the behavioural and learning
idiosyncracies may not be appreciated.

The authors, accordingly, set out
to examine how the Asperger children stand out in terms of language and
literacy performance, and the style of intervention and classroom support that
will best facilitate mainstream inclusion and achievement.

The emphases were upon routine
provision for children in the middle and later stages of junior schooling, and
upon issues that need particular attention such as sensory processing,
pragmatic language, and parent-teacher communication.

It is noted that Asperger
Syndrome first appeared in the Diagnostic and Statistical Manual of Mental
Disorders (DSM) in 1994 as a subcategory of pervasive developmental disorder,
albeit with the recognition that there is wide variation among individuals all
legitimately diagnosed in terms of intellectual capacities, sensory
functioning, social skills, and motor skills.

It is also recognised that
Asperger Syndrome may overlap, and/or be confounded, with other pervasive
disorders such as obsessive-compulsive disorder, non-verbal learning
disability, ADHD, Tourette Syndrome, high functioning autism, Rett Syndrome,
hyperlexia, and pervasive disorder not otherwise specified.

The authors stress that, like
autism, Asperger Syndrome involves impaired social interaction and
communication, along with perseverative behaviour, and delayed or disordered
language development.

However, individuals will vary in
the severity or number of such symptoms, and the extent to which they
experience additional problems.The
example is given of apparently adequate language usage when this superficial
appearance can conceal marked problems with understanding the significance of
what they hear or of drawing inferences. There may also be a weakness in
reading social situations such that behaviour appears inappropriate, further
reducing interaction opportunities.

Teachers’ perceptions or
expectations may be lowered by observed inattentiveness, or anxiety, or
maladaptive behaviours which are misinterpreted as wilfulness or non-compliance
when actually they are a matter of failing to understand what is expected.

Therefore, what is needed is a
greater awareness of these differences coupled with a willingness in the
mainstream sector to accommodate to them and provide support as required.

In particular, Falk-Ross et al
discuss the risk of negative reactions to the common sensory over-sensitivity
among children with Asperger Syndrome and ASD which may lead to some avoidance
behaviours in the classroom, or at least to an interruption in task completion
and an increase in distractibility.

Their prescription includes the
generous use of visual cues and reminders of the routines and tasks to be
completed, simple written copies of basic instructions for steps towards a
given goal, and signals (planned and agreed in advance) by which to re-focus
the pupil if attention is wandering.

Reference is also made to the use
of “manipulatives” such as a squashy ball or “worry stones ” which can be
played with and act as a diverter but not in such a way as to be
disruptive.The advice of an
occupational therapist or speech and language therapist would be valuable in
reducing sensitivities, alongside any actions that can reduce ambient noise or
over-brightness of lighting (including the use of overlays through which to
read black on white print).

Further, the use of computer programmes can be helpful in
providing a focus for attention and for ensuring that steps move on at the pace
of the learner.

Meanwhile, the problems with
interpreting spoken and non-verbal information and for recognising “social”
messages need to be addressed, perhaps via direct teaching of pragmatic
language skills using direct modelling of the component skills … with the
example given of using card games as a means of establishing the routine of
turn-taking.

Various other games, including
board games, can provide the opportunity to establish a pattern of listening and
of communication initiations and responses, while drawing attention to
information emerging from body language, gestures, and facial expressions.

Specific concerns could be
tackled by the use of Social Stories or by examining comic-strip conversations to
highlight the various ways in which communications are made.The authors also recommend electing the
children in question as reporters for a classroom news centre given the need to
prepare the information and rehearse the presentation.Shared story telling or reading between
teacher and child is a further means of providing a model of verbal interaction
and listening.

The authors the discuss the
significance of language routines in offering predictability and organisation
to lessons, and in ensuring that instructions are understood and confusion
avoided.Language and learning are seen
as equally based upon social construction, which further underlines the
potential disadvantages experienced by children with Asperger Syndrome or ASD
which are characterised by socio-communicative problems.

Such difficulties may be readily
observed when it comes to shared discussions, summarizing, and making
comparisons; and the problems are likely to increase as the content becomes
more abstract.Again, the use of visual
organisers and prompts is advocated, along with an implication always to check
understanding before moving on to the next step.

With regard to reading
comprehension, the authors note that performance is most accurate when the
focus is objective and factual, but problems may arise in terms of drawing
implications or when the reader is confronted with idioms or multiple meanings,
and when only limited use is made of surrounding context.

In addition, comprehension can be
inhibited by a tendency towards distractibility and towards literalness, and by
a common weakness in drawing from previous experience or from knowledge gained
in a different context … with implications for working with the pupils in
drawing attention to the significance of details, predicting what might happen
next, and generally moving away from the immediate and literal.

Parents will be valuable partners
in all this, particularly with regard to identifying possible sources of
anxiety, ensuring consistency of handling (including how to manage any crisis),
and agreeing on the amount and form of homework.

With regard to this latter point,
reference is made to Myles and Southwick (1999) who hold that the immediate
post-school period can be very difficult to manage because the child is likely
to be tired and may need to unwind after what could be a challenging and
potentially stressful time in the classroom.

Homework can be problematic
anyway given the need to be clearly organised, to emphasis upon getting things
written down, and the distractibility …. with implications for ensuring that,
if homework is set (and some specialists argue that pupils with ASD should
be spared the further challenge of homework), there is a routine for when and
where it is to be done, prioritisation, and for ensuring a manageable schedule
with breaks built in.(There is a
further requirement for close school-home communication, and for setting
homework which the parents would be able to do !)

Falk-Ross et al conclude by
stressing again the Asperger and ASD core characteristics of narrow/concrete
use of language, perseveration of behaviours (includingverbal behaviour), awkward or limited social
interactions with staff and peers, and the predisposition to sensory overload …
with corresponding needs for decreasing sensory stimulation, differentiation of
demands in terms of goals and processes, and direct teaching and modelling of
social and communication skills.

Within all this is the major
significance of early diagnosis and the establishment of accommodation to the
weaknesses and individualistic styles, in order to reduce the threat of
heightened anxiety and frustrations associated with misunderstanding and
inappropriate expectations.

On the subject of reading
teaching, Broun (2004) introduces her paper by recognising how the development
of communicative and social skills are crucial for children with ASD but
noting, too, that the acquisition of scholastic skills are just as important.

This author traces her emphasis
upon a visual approach to the teaching of reading skills to the guidance
produced by Oelwein (1995) who discussed the most effective strategies for use
with children with Down Syndrome.

The link between this group of
learners and those with ASD is the likely weakness in auditory and phonological
skills and awareness, with the probability that there would be difficulties in
seeking to teach reading via “traditional” and phonics-based approaches.

Broun describes the growing
awareness of the typical visual style among ASD children, and her own study explored
whether the approaches advocated by Oelwein would be effective for these
children, many of whom were observed to be struggling with a phonic emphasis
and who might be turned off literacy by materials which did not match their
style.

Her initial experience of using
such approaches with ASD children, albeit of varying styles and behaviours,
indicated the probability of successful outcomes; and Broun proceeded to adopt
the methodology more widely.

The Oelwein approach teaches to
the strengths of the ASD child, focusing upon the visual preferences.There is a consistent pairing of the printed
word with the spoken word to ensure a link between the visual and auditory
components, with kinaesthetic cues available from the system of matching and
selecting words presented in a range of formats and in completing sentences
from those individual words.

There is a growing awareness that
the ASD population generally do find it more efficient to learn to read by
recognizing whole words; and this approach can producefairly rapidly a sense of achievement and
success which will be motivating for continuing efforts.

By contrast, it is argued that
learning letter sounds and putting them together can be too abstract, and these
phonemes are not readily seen as the building blocks for words. The children
may, in any event, learn the sounds of the letters but still find it very hard
to combine them into sequences in a fluent manner or to decode unfamiliar
words, with the effect that comprehension and meaning are lost.

However, phonics are not ignored
… it is just that they are not the starting point for the development of
reading.When the learner has gained a
sight vocabulary of up to 50 words, (s)he may then learn the letter –sound
association by examining the components of selected andfamiliar words.One starts from a top-down approach, and “backward-chains” from
the whole words to their component sounds.

Meanwhile, it is seen as
important to ensure that the content of reading material is relevant to the
child with his or her particular experiences.So, one would use elements of a language experience approach, using
vocabulary which is meaningful.Thus,
the names of familiar people, pets, favourite foods, toys, etc. are selected
for the gradual development of a repertoire of known words which can be built
into sentences for reading practice by the inclusion of joining words.The subsequent step is to develop vocabulary
which is relevant to topics and subjects being taught.

+

The steps in the Oelwein approach
can be summarized as “Acquisition” – learning to recognize words; “Fluency” –
consistent accuracy in recognizing the words; “Transfer” – the words are
recognized in different formats, or fonts, or contexts; and “Generalisation”
where the words are recognized in any situation.

It is recommended that grids onto
which to print words should be large, and that flashcards should also be large
(around 2 by 5 inches) with the words written in black lower-case form of
around 1 inch.A first step would
involve matching a word to the given word, followed by selecting a given word
on request, and the third step involves saying or signing the word on being
shown a word and being asked“ What
does it say ? ”

Oelwein also stresses the
importance of putting words together to make coherent sentences, and,
therefore, argues for the consistent inclusion into the daily reading routine
of time for the use of the child’s known vocabulary to create sentences.This is followed by encouraging the child to
combine or lengthen the sentences by use of building words like “because”,
“and”, with”, etc..

Fluency and consolidation can be
aided by the use of personal dictionaries or alphabetic scrapbooks.

The final bit of advice is for
access to actual books as soon as practicable in order both to gain a sense of
achievement and to widen experience, while demonstrating the purpose in, and
pleasure to be gained from, reading.Initially, the books can be individually created, containing descriptions
of the child, his/her likes and dislikes, and experiences …. ideally reinforced
by photographs.One can then progress
to actual printed books, with a simple text and clear font, albeit taking them
page by page.

Comprehension can be stimulated
by exercises to match words to the appropriate picture or object or person; and
then match sentences in the same manner; with the child also encouraged to
produce simple descriptive sentences to go with a picture.

Broun concludes by describing how
many children, taught to read by these top-down and language-experience
approaches, have shown a corresponding increase in their spoken vocabulary and
in their consistent willingness to use spoken language in the form of whole
sentences.

The work of O’Connor and Klein
(2004) deals with those (older) pupils with ASD who may show adequate or better
decoding skills and reading accuracy, but who show poor comprehension of the
content.

They, too, suggest that there has
been relatively little focus upon scholastic skills because the social or
behavioural needs of children with autism have been seen as more critical.However, they also recognize the recent
increase in the number of children diagnosed, including many with high
functioning autism and Asperger Syndrome whose cognitive and language skills
are less impaired and who are likely to be part of a mainstream class and to
face the scholastic challenges appropriate to the age group.

It is noted by various authors
(egHappe 1997) that many of these high
functioning pupils do show distinctive weaknesses in their reading … notably
the disparity between good word reading and poor comprehension.In some cases, there has been reference to
“hyperlexia” where reading accuracy is very good but there is virtually no
understanding of what is read.

(This is not to say that all
pupils with these difficulties are autistic; nor that all pupils at the higher
end of the autistic spectrum will have a degree of hyperlexia.However, this pattern is relatively common
among the ASD population.)

In their review of studies,
O’Connor and Klein describe the frequent pattern of adequate decoding of new
words or non-words, with the implication that phonetic strategies are
unimpaired , along with an ability to deal with phonetically irregular words,
suggesting adequate lexical skills as well.However, it is quite common for these pupils to show impaired or absent
comprehension; and there is further evidence (Goldstein et al 1994) that the
problems with comprehension become more marked over time, with adolescents
showing even poorer skills than children, with the implication for greater
disadvantage as there arises a greater demand for drawing inferences and
looking beyond the immediate and obvious.

Meanwhile, there is evidence that
single-word reading comprehension among the high functioning ASD pupils is
largely intact, but that for longer linguistic units there will be increasing
difficulty.Some syntactic skills might
be present, such as the ability to complete cloze tasks with syntactically correct
words, but the problems arise as the grammatical complexity and semantic
complexity become greater.

There may also be problems in
integrating information, such as information from a previously read passage
with that from current reading.

The authors then refer to
“anaphora” … the means of gaining coherence from a text, and the ability to
make sense of what is being read by referring back to what has gone
before.For example, anaphora may come
into play when a pronoun like “he” or “she” appears in the text and it may be
necessary to remind oneself to whom the pronoun refers.It is suggested that individuals with ASD,
with their problems in managing attention, would find it hard to cope with
these cues.

It is also noted that the
children in question are likely to have problems in using prior knowledge to
interpret the significance of text, and they may cope with factual recall
questions directly concerned with their current reading, but be unable to deal
with questions which call for the common sense application of general knowledge
gleaned from previous reading.The
individuals may possess the appropriate knowledge but do not apply it
during their further reading.

The study completed by O’Connor
and Klein themselves set out to investigate ways of supporting15 year old
learners’ understanding of text at the level of sentence or above by using “
procedural facilitation ”.

This involves offering prompts by
which to stimulate executive processes.For example, the learners could be set pre-reading questions with a view
to drawing direct attention to prior knowledge and to prime the process of
activating that existing knowledge.Alternatively, use could be made of anaphoric prompting in checking to
whom or what pronouns refer…. encouraging the readers to pause and check that
they are following the text accurately, and to look back as necessary to
re-read what has gone before.

A third possibility is a cloze
task which requires the reader to make predictions as they read, and implies
the need to go back and re-read passages to consolidate their understanding.

To check understanding and
comprehension, the readers might be asked to retell the story in their own
words; to describe the main idea; to offer a good title; to make inferences via
why and how questions; to answer who, what, when, and where questions; and to
detect sentences which are incongruent or irrelevant to the main theme.

The results indicated that this
procedural facilitation significantly enhance the readers’ comprehension of the
texts.Analysis highlighted the
particular value of anaphoric cues whose effect was felt by the majority of the
sample, while the effects of the other two approaches were observable but not
statistically significant.

Meanwhile, activation of previous
knowledge was confirmed to have risks as much as benefits.Activating previous knowledge usually does
improve recall and comprehension, but the current study indicated that, for
some of the ASD sample, the cues could activate prior knowledge that was
irrelevant or inaccurate, but that this information perseverated and got in the
way of the current comprehension targets.

This latter problem is not unique
to individuals with ASD, but the strong and idiosyncratic interests of this
group could lead to a greater probability of conflict … and this very conflict
may not be recognised given the pattern of non-monitoring of comprehension.

Self monitoring is confirmed as
challenging for the ASD group, with no spontaneous readiness to verify
understanding or repair comprehension … hence some observable benefits from the
direct prompting via the anaphoric cues and cloze demands.

The authors conclude by
recommending to teachers and parents the likely benefits of encouraging readers
to check back over what they are reading.Computer based learning could be particularly valuable in highlighting
anaphoric cues, with the reader expected to identify the referent of a pronoun,
for example, before moving on.Such
prompts could gradually be faded as the learner becomes used to a self-checking
routine.

What matters, in any event, is an
awareness of this comprehension weakness, and the corresponding need to
intervene. The problems will not show spontaneous remission.

Finally, one would draw attention
to the work of Murdick et al (2004) who also were concerned with hyperlexia,
albeit not focusing simply upon the ASD population but concerned with that
wider sample of readers who share the pattern of adequate decoding and poor
comprehension.

Their concern is increased by the
awareness that the resulting disadvantage in the classroom (which may not be
readily identified) can be associated with social and behavioural problems.

These authors also note that the
child with hyperlexia might be misdiagnosed … as having a language disorder,
Asperger Syndrome, ADHD, hearing loss, or learning difficulty.In fact, one school of thought (Ray 1999)
has it that hyperlexia should be included within the ASD category given the
considerable sharing of characteristics between the two groups.

The term “hyperlexia” was first
coined by Silberberg and Silberberg (1967) to describe those individuals with
superior word recognition but delayed language abilities marked by poor
understanding and comprehension of the written word. However, Murdick et al
hold that this condition is not well understood, and note that it does not
stand as an identifiable category of need according to the Individuals with
Disabilities Education Act.

The American Hyperlexia
Association does not offer a clear definition, but refers to three
characteristics for the identification of hyperlexia … precocious reading
ability, significant difficulties in understanding and using language, and
problems with social skills.Given
this, one can see how hyperlexia and ASD can be confused, or seen as showing
considerable overlap.

The children in question often
show spontaneous beginning of reading before the age of two years, and may be
competent in reading accuracy by 5 years … perhaps showing reading skill in
advance of spoken language skills.

However, these children may
depend upon rote learning and develop an unorganised store of information which
may not be readily available for use in context.

It is further argued that the
children in question use language in ways that are differentiable from those
observed in children without the hyperlexic condition.For example, it is reported that most of the
children utter their first words during the second year but may lose these
words before reaching two years and have to relearn them at a later stage.

The early learning is commonly
marked by echolalia and learned in whole phrases rather than word by word.

Speech may present as repetitive
and lacking in pragmatics, and, in this, can be similar to that observed among
children with ASD.

Reference is then made to
Kupperman et al (1995) who describe how the majority of children with
hyperlexia show behaviours which can interfere with social interaction and
social skill development.These
behaviours may include non-compliance, ritualistic behaviour, and self stimulation,
and are considered to work towards a sameness of routines with corresponding
anxiety about change and transition …. again, similar to children with
ASD.

It is the hypothesis of Kupperman
et al that these social and behavioural issues reflect deficits in the ability
accurately and rapidly to process and comprehend language.

With regard to intervention,
Murdick et al review evidence and opinion with the recommendation that the
children will require classroom support in terms of the classroom setting and
nature/presentation of demands. Ideally the class should be small but providing
a range of normally developing peers who can provide positive language
models.

A clear structure and routine are
required, with plentiful use of visual aids and prompts such as mind maps or
simply highlighting the most salient parts of texts, along with adequate adult
time by which to check the children’s understanding and their focus upon the
task in hand.There may need for
attention when the text in question contains idioms and figures of speech that
may be confusing when treated literally; and for pre-teaching of certain
vocabulary or deliberate introduction of background information as new concepts
and data are introduced.

The authors conclude by referring
to the complex patterns of strengths and weaknesses that are displayed by the
children with hyperlexia, and their concern is that teachers or parents may be
influenced by the superficial show of good reading and fail to appreciate the
underlying weaknesses in understanding, with the corresponding risk of
inappropriate demands and expectations leading to stress and deteriorating
behaviour.